Live-in care packages: what social workers need to know

Social workers are often among the first to see that someone can no longer manage safely at home, and live-in care is one of the options to weigh. This guide explains what a live-in care package covers, how a referral to Hometouch works, how it can be funded, and what clinical oversight sits behind it.

This guide covers England. Funding and regulation differ in Scotland and Wales.

Key insights

• A live-in care package means one carer lives in the person’s home and supports them day and night, built around their needs
• A referral needs the person’s consent first, then their name, contact details, relevant health conditions, care needs, location and estimated start date
• In England, live-in care can be funded privately, through NHS Continuing Healthcare, or through a council personal budget, depending on assessment
• Hometouch offers a CQC-regulated service and an introductory service, and the responsibilities differ between them

What is a live-in care package?

A live-in care package means one carer lives in the person’s home and supports them through the day and night. The carer typically helps with personal care such as washing and dressing, medication prompts, meal preparation, light housekeeping, getting out and about, and companionship. Each package is built around the person’s needs, routines and preferences, so no two are the same. Hometouch’s carers are self-employed and vetted by Hometouch.

Who does live-in care help?

Live-in care may suit someone who needs support with daily activities and wants to stay in their own home. That includes older people, people living with dementia or complex conditions, and adults with disabilities. It may also suit families who need continuous support because of the person’s health, or who want to avoid a move into a care home or nursing home.

When to consider live-in care covers the point at which it becomes the right option. Live-in care is not 24-hour nursing care.

What are the benefits of live-in care?

Live-in care keeps the person in their own home. The benefits of live-in care go beyond that:

• The person keeps their own home, routines and schedule instead of fitting a care home timetable. For people living with dementia, a move to an unfamiliar place can be unsettling
• One carer supports one person, matched to their needs
• A say in who the carer is. The family is involved in choosing the carer, and is not simply assigned one
• The care package can be adjusted as needs change, without a move or a change of provider
• The person stays close to neighbours, family and friends, and can keep a pet at home
• Couples can stay together at home, and in most cases one carer can support both people
• Having a carer in the home can give a family carer a break

How does a referral to Hometouch work?

A referral is how you introduce someone to Hometouch, with their consent, so that the team has the details it needs to consider their care. You might refer when someone you are supporting needs help through the day and night and wants to stay in their own home, for example after a hospital discharge, or when the alternative being considered is a move into a care home or nursing home.

These are the steps for making a referral.

1. Get the person’s consent. This is necessary before their details are shared with Hometouch
2. Contact the partnerships team at partnerships@myhometouch.com with the person’s name, contact details, relevant health conditions, care needs, location and estimated start date. The more detail, the better

How long each stage takes depends on the person’s location, the complexity of the case, carer matching and the start date. For families, Hometouch’s process includes carer matching, an assessment and a care plan, described in how to arrange live-in care.

How can live-in care be funded?

In England, live-in care can be paid for in several ways, and the route depends on the person’s assessment and finances. Funding rules differ in Scotland and Wales.

• Many people pay privately. Live-in care with one carer typically costs £1,200 to £1,500 a week, about £170 to £215 a day. These figures are a guide, not a quote
• If someone’s needs are assessed as primarily a health need, NHS Continuing Healthcare can fund care at home. It is not means-tested, and eligibility is decided by a formal assessment. A social worker can complete the CHC Checklist, which starts the process
• For someone eligible for CHC, a personal health budget can give them more control over which provider delivers their care
• After a needs assessment, a council that finds someone eligible sets a personal budget, and should offer direct payments as an option. The council also carries out a financial assessment, which affects how much it pays. Whether the council will pay for live-in care is the council’s decision, based on its assessment
• Attendance Allowance may contribute for people at State Pension age or over

What does the home need for a live-in carer?

What a live-in carer needs starts with a private room of their own, access to bathroom facilities and time away from the person they support. Hometouch recommends a two-hour break each day, and food is provided by the family or through a weekly food allowance for the carer. When someone is considering live-in care, it helps to know whether there is a spare room for the carer.

How are Hometouch’s carers vetted?

Hometouch’s carers are self-employed. Before they take placements, Hometouch checks their ID, right to work, qualifications and Enhanced DBS certificate, which must be on the DBS Update Service, and follows up their references. Each carer also has a phone interview and a face-to-face interview with the recruitment team, and completes clinical training, including dementia training from Hometouch’s clinical team, before starting placements.

What clinical oversight sits behind the care?

Hometouch was founded by Dr Jamie Wilson, a dementia specialist who worked in the NHS. The clinical team reviews each enquiry, and for regulated care a clinical care manager creates the custom care plan and reviews it as needs change. Where someone is living with dementia, carers receive training from the clinical team before they begin.

Hometouch’s regulated service is registered with the Care Quality Commission in England. With the introductory service, Hometouch matches and vets the carer and the family manages the arrangement, so the responsibilities differ. The difference between regulated and introductory agencies is worth understanding before a referral.

Frequently asked questions

What information does a referrer need to provide?

A referrer needs to provide the person’s name, contact details, relevant health conditions, care needs, location and estimated start date. The more detail you can share, the better, and the person’s consent is needed first.

Does the person need to consent to a referral?

Yes. The person’s consent is needed before their details are shared with Hometouch, so it is worth confirming this before you make contact.

What is the difference between regulated and introductory live-in care?

With regulated care, Hometouch manages the care arrangement under its CQC registration, with a clinical care manager overseeing the plan. With introductory care, Hometouch matches and vets the carer, and the family manages the arrangement directly. Both involve the same matching process, and the responsibilities differ, so it is worth asking which service is being offered.

Can NHS Continuing Healthcare fund live-in care?

Yes, in some cases. In England, NHS Continuing Healthcare can fund care at home, including live-in care, for people whose needs are assessed as primarily a health need. Eligibility is decided by a formal assessment, and a diagnosis alone does not guarantee it.

Final thoughts

Live-in care suits people who need support through the day and night and want to stay in their own home. For a referral, get the person’s consent and share their details with Hometouch. If you would like to talk a case through first, our care experts can help. No pressure, just clear guidance.